…Your chiropractor prescribes 30 visits, but insurance will only cover 20…
…Your primary care doctor prescribes a chiropractic evaluation, but Medicare doesn’t cover this…
…You change jobs but under your new insurance, your chiropractor of many years is now out of network…
We can call our insurance companies and ask for exceptions and make appeals, but generally these efforts don’t yield the outcome we need – coverage for necessary treatments. As your doctor, we want nothing more than to see you get well, but we are limited in offering discounts for services not covered by insurance.
Under federal law, it is illegal for chiropractors to provide discounts for patients.
According to the Department of Health and Human Services (HHS), Office of Inspector General (OIG), “It is unlawful to routinely waive co-payments, deductibles, coinsurances or other patient responsibility payments.” (67 Fed. Reg. 72,896 (Dec. 9, 2002). This applies to health care and services paid by Medicare, TRICARE/CHAMPUS, and any other program paid partially or in full with federal funds. This also includes “take what insurance pays” (TWIP) policies.1 While we want to help our uninsured and underinsured patients receive the care that they need, we also want to operate inside of federal and state regulations.
This is where the ChiroHealthUSA program can help. ChiroHealthUSA allows chiropractors to offer discounted services to uninsured and underinsured patients for their chiropractic-related expenses. “This program is exactly what doctors have been looking for to help them offer legal discounts to their patients. [It] finally provides our doctors a way to help their patients without putting their practices at risk”, says Unified Virginia Chiropractic Association (VCA) President, Dr. Brad Robinson.
ChiroHealthUSA is a contracted network that allows doctors to offer discounted services to patients who are members of the network. It’s important to know that it is NOT an insurance program. You will still have to pay for the care you receive that is not covered by your insurance or Medicare. However, because of Carney Chiropractic Center’s participation in this program, we are legally permitted to extend special discounts on those services that your insurance will not cover.
By joining ChiroHealthUSA, you immediately become a member with no pre-approval necessary, and are eligible to enjoy discounted fees on your chiropractic care when your insurance falls short. Your membership in the program is just $49 per year and includes you and everyone in your household. It does not automatically renew, and you can cancel risk free within the first 30 days without losing any previous discounts from us.
How does it work?
Your membership allows you to access all of our services at a 30 percent discount, with a maximum fee per day, so you will always know how much it will cost before walking through the door. We also are able to extend additional discounts to those with limited services or partial insurance coverage, such as the case with Medicare patients.
Medicare only pays for the spinal manipulation (also known as the adjustment) performed by the chiropractor. What many patients don’t know is that Medicare will not pay for your initial exam to see the doctor, which can be a costly, especially for those on a fixed income. Medicare also does not cover any physical therapy even if deemed necessary by your chiropractor. ChiroHealthUSA allows us to offer flat fees for both of these non-covered services.
This flat fee for partial coverage applies not only to Medicare patients, but other insurance patients as well. For example, you may exhaust your chiropractic benefit but have additional physical therapy benefits available. The flat fee arrangement make the visits equal to, and sometimes less than, the cost of typical copay for you.
In addition, although you will hear Dr. Loomis talk about it from your first visit, no insurance company covers ongoing “maintenance” chiropractic care. Since your membership fee for ChiroHealthUSA is good for an entire year from the date you join, most maintenance patients enjoy those regular “tune up” adjustments at a 30% discount.
How can I join?
To join ChiroHealthUSA, simply complete a membership application in our office. We will collect your membership fee (you can pay by cash, credit card, or check) and submit it directly to ChiroHealthUSA. You will be given a temporary card to use until your permanent membership card arrives in 3-4 weeks.
It’s an easy application, a low membership fee, and well worth joining according to the hundreds of our patients that currently use the program. “It’s so easy,” says a long-time maintenance patient Michelle, who travels regularly for work and seeks adjustments after long flights. “If you are invested in regular care of your body, it makes perfect sense to use the program.”
So if you’re concerned about the lack of coverage that your insurance company provides, or you do not have insurance, don’t let that stop you from getting the treatment that you need. Make your appointment today and let us help you sort out the coverage and payment details.